Tag: statistics

Turk Arch Pediatr. 2023 May;58(3):268-273. doi: 10.5152/TurkArchPediatr.2023.22247.

ABSTRACT

OBJECTIVE: To determine changes caused by the effect of the COVID-19 pandemic by examining the children admitted to our hospital because of poisoning during the pandemic and comparing these with data from a study conducted in the pre-pandemic period.

MATERIALS AND METHODS: A retrospective examination was made of children who were admitted to our pediatric emergency department with poisoning between March 2020 and March 2022.

RESULTS: Of the 82 (0.7%) patients admitted to the emergency department, 42 (51.2%) were girls, the mean age was 6.43 ± 5.62 years, and the majority of children (59.8%) were under 5 years of age. The poisonings were determined to be accidental in 85.4% of cases, 13.4% were suicide attempts, and 1.2% were iatrogenic. Poisonings occurred most frequently (97.6%) at home and most frequently (85.4%) by digestive tract. The most common causative agent (68%) was non-pharmacological agents. Caustic-corrosive substances were determined in 39% of cases, medical drugs in 32%, toxic gases in 11%, alcohol (hand sanitizers) in 8.5%, insecticide-pesticide in 6.1%, food in 1.2%, and animal bites in 1.2%. Compared to the study conducted in our hospital in 2013-2014, the difference in terms of factors causing poisoning was statistically significant (P < .001). Of the current study cases, 14 (17.1%) were followed up in the intensive care unit, and no mortality developed.

CONCLUSIONS: The period of the COVID-19 pandemic was seen to cause an increase in poisoning rates with caustic-corrosive substances, alcohol (hand disinfectants), and toxic gases. Families should be made aware of this issue and take special precautions.

PMID:37144259 | DOI:10.5152/TurkArchPediatr.2023.22247

Br J Health Psychol. 2023 May 4. doi: 10.1111/bjhp.12664. Online ahead of print.

ABSTRACT

BACKGROUND: Behaviour change counselling (BCC) is an adaptation of motivational interviewing (MI) designed to maximize the effectiveness of time-limited health behaviour change consultations. To improve intervention quality and understanding of treatment effects, it is recommended that evaluations of health behaviour change interventions incorporate existing fidelity frameworks (e.g. The National Institutes of Health [NIH] Behaviour Change Consortium) and ensure that treatment fidelity is assessed and reported.

PURPOSE: This systematic review was designed to examine (a) adherence to NIH fidelity recommendations, (b) provider fidelity to BCC and (c) impact of these variables on the real-world effectiveness of BCC for adult health behaviours and outcomes.

METHODS AND RESULTS: Searches of 10 electronic databases yielded 110 eligible publications describing 58 unique studies examining BCC delivered within real-world healthcare settings by existing providers. Mean study adherence to NIH fidelity recommendations was 63.31% (Range 26.83%-96.23%). Pooled effect size (Hedges g) for short-term and long-term outcomes was .19 (95% CI [.11, .27]) and .09 (95% CI [.04, .13]), respectively. In separate, random-effects meta-regressions, neither short-term nor long-term effect sizes were significantly modified by adherence to NIH fidelity recommendations. For the subgroup of short-term alcohol studies (n = 10), a significant inverse relationship was detected (Coefficient = -.0114, 95% CI [-.0187, -.0041], p = .0021). Inadequate and inconsistent reporting within the included studies precluded planned meta-regression between provider fidelity and BCC effect size.

CONCLUSIONS: Further evidence is needed to clarify whether adherence to fidelity recommendations modifies intervention effects. Efforts to promote transparent consideration, evaluation and reporting of fidelity are urgently needed. Research and clinical implications are discussed.

PMID:37144242 | DOI:10.1111/bjhp.12664

Zhonghua Yu Fang Yi Xue Za Zhi. 2023 May 4;57:741-746. doi: 10.3760/cma.j.cn112150-20220617-00621. Online ahead of print.

ABSTRACT

In 2021, a total of 151 pregnant women were selected from the suburb of Shanghai. A questionnaire survey was conducted to obtain data about maternal age, gestational week, total annual household income, education level and passive smoking among pregnant women and one spot urine was collected. The concentrations of eight neonicotinoid pesticides and four metabolites in urine were measured by ultra-high performance liquid chromatography-tandem quadrupole time-of-flight mass spectrometry. The differences in detection frequencies and concentrations of neonicotinoid pesticides and their metabolites among pregnant women with different characteristics were compared, and the influencing factors of the detection of neonicotinoid pesticides in urine were analyzed. The results showed that at least one neonicotinoid pesticide was detected in 93.4% (141 samples) of urine samples. The detection frequencies of N-desmethyl-acetamiprid, clothianidin, thiamethoxam, and N-desmethyl-clothianidin were high, about 78.1% (118 samples), 75.5% (114 samples), 68.9% (104 samples), and 44.4% (67 samples), respectively. The median concentration of the sum of all neonicotinoid pesticides was 2.66 μg/g. N-desmethyl-acetamiprid had the highest detection concentration with a median concentration of 1.04 μg/g. A lower urinary detection frequency of imidacloprid and its metabolites was seen in pregnant women aged 30-44 years [OR (95%CI): 0.23 (0.07-0.77)]. A higher detection frequency of clothianidin and its metabolites was seen in pregnant women with per capita annual household income≥100, 000 yuan [OR (95%CI): 6.15 (1.56-24.28)]. There was widespread exposure to neonicotinoid pesticides and their metabolites in pregnant women from the suburb of Shanghai, which might pose potential health risks to pregnant women, and maternal age and household income were potential influencing factors of the exposure to neonicotinoid pesticides.

PMID:37142424 | DOI:10.3760/cma.j.cn112150-20220617-00621

Tob Control. 2023 May 4:tc-2022-057618. doi: 10.1136/tc-2022-057618. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the tobacco-attributable burden on disease, medical costs, productivity losses and informal caregiving; and to estimate the health and economic gains that can be achieved if the main tobacco control measures (raising taxes on tobacco, plain packaging, advertising bans and smoke-free environments) are fully implemented in eight countries that encompass 80% of the Latin American population.

DESIGN: Markov probabilistic microsimulation economic model of the natural history, costs and quality of life associated with the main tobacco-related diseases. Model inputs and data on labour productivity, informal caregivers’ burden and interventions’ effectiveness were obtained through literature review, surveys, civil registrations, vital statistics and hospital databases. Epidemiological and economic data from January to October 2020 were used to populate the model.

FINDINGS: In these eight countries, smoking is responsible each year for 351 000 deaths, 2.25 million disease events, 12.2 million healthy years of life lost, US$22.8 billion in direct medical costs, US$16.2 billion in lost productivity and US$10.8 billion in caregiver costs. These economic losses represent 1.4% of countries’ aggregated gross domestic products. The full implementation and enforcement of the four strategies: taxes, plain packaging, advertising bans and smoke-free environments would avert 271 000, 78 000, 71 000 and 39 000 deaths, respectively, in the next 10 years, and result in US$63.8, US$12.3, US$11.4 and US$5.7 billions in economic gains, respectively, on top of the benefits being achieved today by the current level of implementation of these measures.

CONCLUSIONS: Smoking represents a substantial burden in Latin America. The full implementation of tobacco control measures could successfully avert deaths and disability, reduce healthcare spending and caregiver and productivity losses, likely resulting in large net economic benefits.

PMID:37142423 | DOI:10.1136/tc-2022-057618

J Sport Rehabil. 2023 May 4:1-6. doi: 10.1123/jsr.2022-0356. Online ahead of print.

ABSTRACT

CONTEXT: Instrument-assisted soft tissue mobilization (IASTM) is a popular myofascial treatment utilized by health care professionals. Currently, there is a lack of research on the effects of a light pressure IASTM treatment on the forearm region. The purpose of this study was to explore the effects of a light pressure IASTM technique at different application rates on grip strength and muscle stiffness. This study was considered exploratory with the goal of establishing methodology for future controlled studies.

DESIGN: Observational pretest and posttest clinical study.

METHODS: Twenty-six healthy adults underwent one light pressure IASTM treatment to their dominant forearm muscles. Participants were allocated to 2 groups of 13 based upon treatment rate: 60 beats per minute and 120 beats per minute. Participants were tested pretreatment and posttreatment for grip strength and tissue stiffness via diagnostic ultrasound. One-way analyses of covariance were used to assess group differences posttreatment for grip strength and tissue stiffness.

RESULTS: Statistically significant posttreatment changes for grip strength and tissue stiffness were not found. Despite the nonstatistical significance, there were small decreases in grip strength and tissue stiffness. Faster (120 beats/min) IASTM application may have produced clinically meaningful decreases in grip strength along with a small decrease in tissue stiffness.

CONCLUSIONS: This report helps to establish methodology for future controlled studies on this topic. Sports medicine professionals should consider these results as exploratory and interpret them with caution. Future research is needed to confirm these findings and begin to postulate possible neurophysiological mechanisms.

PMID:37142408 | DOI:10.1123/jsr.2022-0356

J Neurol Neurosurg Psychiatry. 2023 May 4:jnnp-2022-330851. doi: 10.1136/jnnp-2022-330851. Online ahead of print.

ABSTRACT

BACKGROUND: Several genetic factors are associated with the pathogenesis of sporadic amyotrophic lateral sclerosis (ALS) and its phenotypes, such as disease progression. Here, in this study, we aimed to identify the genes that affect the survival of patients with sporadic ALS.

METHODS: We enrolled 1076 Japanese patients with sporadic ALS with imputed genotype data of 7 908 526 variants. We used Cox proportional hazards regression analysis with an additive model adjusted for sex, age at onset and the first two principal components calculated from genotyped data to conduct a genome-wide association study. We further analysed messenger RNA (mRNA) and phenotype expression in motor neurons derived from induced pluripotent stem cells (iPSC-MNs) of patients with ALS.

RESULTS: Three novel loci were significantly associated with the survival of patients with sporadic ALS-FGF1 at 5q31.3 (rs11738209, HR=2.36 (95% CI, 1.77 to 3.15), p=4.85×10^-9), THSD7A at 7p21.3 (rs2354952, 1.38 (95% CI, 1.24 to 1.55), p=1.61×10^-8) and LRP1 at 12q13.3 (rs60565245, 2.18 (95% CI, 1.66 to 2.86), p=2.35×10^-8). FGF1 and THSD7A variants were associated with decreased mRNA expression of each gene in iPSC-MNs and reduced in vitro survival of iPSC-MNs obtained from patients with ALS. The iPSC-MN in vitro survival was reduced when the expression of FGF1 and THSD7A was partially disrupted. The rs60565245 was not associated with LRP1 mRNA expression.

CONCLUSIONS: We identified three loci associated with the survival of patients with sporadic ALS, decreased mRNA expression of FGF1 and THSD7A and the viability of iPSC-MNs from patients. The iPSC-MN model reflects the association between patient prognosis and genotype and can contribute to target screening and validation for therapeutic intervention.

PMID:37142397 | DOI:10.1136/jnnp-2022-330851

Lancet Oncol. 2023 May;24(5):e197-e206. doi: 10.1016/S1470-2045(23)00110-9.

ABSTRACT

Patient-reported outcomes (PROs) are increasingly used in single-arm cancer studies. We reviewed 60 papers published between 2018 and 2021 of single-arm studies of cancer treatment with PRO data for current practice on design, analysis, reporting, and interpretation. We further examined the studies’ handling of potential bias and how they informed decision making. Most studies (58; 97%) analysed PROs without stating a predefined research hypothesis. 13 (22%) of the 60 studies used a PRO as a primary or co-primary endpoint. Definitions of PRO objectives, study population, endpoints, and missing data strategies varied widely. 23 studies (38%) compared the PRO data with external information, most often by using a clinically important difference value; one study used a historical control group. Appropriateness of methods to handle missing data and intercurrent events (including death) were seldom discussed. Most studies (51; 85%) concluded that PRO results supported treatment. Conducting and reporting of PROs in cancer single-arm studies need standards and a critical discussion of statistical methods and possible biases. These findings will guide the Setting International Standards in Analysing Patient-Reported Outcomes and Quality of Life Data in Cancer Clinical Trials-Innovative Medicines Initiative (SISAQOL-IMI) in developing recommendations for the use of PRO-measures in single-arm studies.

PMID:37142381 | DOI:10.1016/S1470-2045(23)00110-9

Am J Orthod Dentofacial Orthop. 2023 May;163(5):732-734. doi: 10.1016/j.ajodo.2023.02.005.

NO ABSTRACT

PMID:37142356 | DOI:10.1016/j.ajodo.2023.02.005

BMJ Open. 2023 May 4;13(5):e071059. doi: 10.1136/bmjopen-2022-071059.

ABSTRACT

INTRODUCTION: Digital game-based training interventions are scalable solutions that may improve cognitive function for many populations. This protocol for a two-part review aims to synthesise the effectiveness and key features of digital game-based interventions for cognitive training in healthy adults across the life span and adults with cognitive impairment, to update current knowledge and impact the development of future interventions for different adult subpopulations.

METHODS AND ANALYSIS: This systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. A systematic search was performed in PubMed, Embase, CINAHL, Cochrane Library, Web of Science, PsycINFO and IEEE Explore on 31 July 2022 for relevant literature published in English from the previous 5 years. Experimental, observational, exploratory, correlational, qualitative and mixed methods studies will be eligible if they report at least one cognitive function outcome and include a digital game-based intervention intended to improve cognitive function. Reviews will be excluded but retained to search their reference lists for other relevant studies. All screening will be done by at least two independent reviewers. The appropriate Joanna Briggs Institute Critical Appraisal Tool, according to the study design, will be applied to perform the risk of bias assessment. Outcomes related to cognitive function and digital game-based intervention features will be extracted. Results will be categorised by adult life span stages in the healthy adult population for part 1 and by neurological disorder in part 2. Extracted data will be analysed quantitatively and qualitatively, according to study type. If a group of sufficiently comparable studies is identified, we will perform a meta-analysis applying the random effects model with consideration of the I² statistic.

ETHICS AND DISSEMINATION: Ethics approval is not applicable for this study since no original data will be collected. The results will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO REGISTRATION NUMBER: CRD42022351265.

PMID:37142320 | DOI:10.1136/bmjopen-2022-071059

BMJ Open. 2023 May 4;13(5):e066829. doi: 10.1136/bmjopen-2022-066829.

ABSTRACT

DESIGN: Analyst blinded, parallel, multi-centre, randomised controlled trial (RCT).

PARTICIPANTS: People with confirmed diagnoses of cancer (head and neck, skin or colorectal) attending follow-up consultation 3 months post-treatment between 2015 and 2020.

INTERVENTION: Holistic needs assessment (HNA) or care as usual during consultation.

OBJECTIVE: To establish whether incorporating HNA into consultations would increase patient participation, shared decision making and postconsultation self-efficacy.

OUTCOME MEASURES: Patient participation in the consultations examined was measured using (a) dialogue ratio (DR) and (b) the proportion of consultation initiated by patient. Shared decision making was measured with CollaboRATE and self-efficacy with Lorig Scale. Consultations were audio recorded and timed.

RANDOMISATION: Block randomisation.

BLINDING: Audio recording analyst was blinded to study group.

RESULTS: 147 patients were randomised: 74 control versus 73 intervention.

OUTCOME: No statistically significant differences were found between groups for DR, patient initiative, self-efficacy or shared decision making. Consultations were on average 1 min 46 s longer in the HNA group (respectively, 17 m 25 s vs 15 min 39 s).

CONCLUSION: HNA did not change the amount of conversation initiated by the patient or the level of dialogue within the consultation. HNA did not change patient sense of collaboration or feelings of self-efficacy afterwards. HNA group raised more concerns and proportionally more emotional concerns, although their consultations took longer than treatment as usual.

IMPLICATIONS FOR PRACTICE: This is the first RCT to test HNA in medically led outpatient settings. Results showed no difference in the way the consultations were structured or received. There is wider evidence to support the roll out of HNA as part of a proactive, multidisciplinary process, but this study did not support medical colleagues facilitating it.

TRIAL REGISTRATION NUMBER: NCT02274701.

PMID:37142317 | DOI:10.1136/bmjopen-2022-066829